Behavioral activation and smoking cessation outcomes: The role of depressive symptoms

Carmela Martínez-Vispo; Ana López-Durán; Carmen Senra; Rubén Rodríguez-Cano; Elena Fernández Del Río; Elisardo Becoña

doi:10.1016/j.addbeh.2019.106183

Behavioral activation and smoking cessation outcomes: The role of depressive symptoms

Addict Behav. 2020 Mar:102:106183. doi: 10.1016/j.addbeh.2019.106183. Epub 2019 Oct 19.

Authors

Carmela Martínez-Vispo¹, Ana López-Durán², Carmen Senra³, Rubén Rodríguez-Cano⁴, Elena Fernández Del Río⁵, Elisardo Becoña²

Affiliations

¹ Smoking Cessation and Addictive Disorders Unit, Faculty of Psychology, University of Santiago de Compostela, Galicia, Spain. Electronic address: carmela.martinez@usc.es.
² Smoking Cessation and Addictive Disorders Unit, Faculty of Psychology, University of Santiago de Compostela, Galicia, Spain; Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Galicia, Spain.
³ Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Galicia, Spain.
⁴ Smoking Cessation and Addictive Disorders Unit, Faculty of Psychology, University of Santiago de Compostela, Galicia, Spain.
⁵ Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain.

PMID: 31809878
DOI: 10.1016/j.addbeh.2019.106183

Abstract

Introduction: Depressive symptoms are related to smoking cessation outcomes. We examined the effects of behavioral activation (BA), as part of a cognitive behavioral intervention to quit smoking, in terms of abstinence rates according to depressive symptom level. We also analyzed whether BA could differentially benefit participants with higher versus lower anhedonia.

Methods: The sample was composed of 183 smokers (M_age = 45.3; 62.8% female) who participated in a randomized clinical trial assessing the effects of a BA intervention compared to a standard intervention. Smoking outcomes were biochemically confirmed point prevalence abstinence, and abstinence days after treatment during one year follow-up. The intensity of depressive symptomatology and anhedonic symptoms were assessed using the Beck Depression Inventory-II.

Results: No differences in abstinence rates were found in relation to depressive symptom level. The BA condition (vs. standard condition) predicted greater abstinence rates (OR = 1.91) in participants with lower scores on depressive symptoms, whereas in participants with higher scores, it did not (OR = 1.17). Moreover, the BA condition predicted greater abstinence rates in participants with lower scores on anhedonia. When examining days of abstinence during the one-year follow-up period, a significant interaction was found between depressive symptoms and treatment condition, favoring the BA condition.

Conclusion: BA implemented as part of a cognitive behavioral intervention to quit smoking improves long-term abstinence rates, especially among those with fewer depressive symptoms.

Keywords: Anhedonia; Behavioral activation; Depressive symptomatology; Smoking cessation.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Anhedonia*
Behavior Therapy / methods*
Cigarette Smoking / psychology
Cigarette Smoking / therapy*
Cognitive Behavioral Therapy / methods*
Depression / psychology*
Female
Humans
Male
Middle Aged
Smoking Cessation / methods*
Smoking Cessation / psychology
Treatment Outcome